Abstract

Objective: Epstein-Barr virus (EBV) can cause different clinical pictures from infectious mononucleosis (IM) to malignancies such as B-cell lymphomas, Burkitt’s lymphoma, nasopharyngeal carcinoma, and Hodgkin lymphoma. VCA-IgM, VCA-IgG, EBNA-1 IgG antibodies are the most commonly used antibodies in revealing the serological profile. This study aimed to examine the serological profiles of patients with suspected EBV infection and to interpret the atypical profiles encountered.

Methods: The results of VCA-IgM, VCA-IgG, and EBNA-1 IgG antibodies studied in the Microbiology Laboratory between 2017-2019 were evaluated retrospectively. EBV serological tests (VCA-IgM, VCA-IgG, and EBNA-1 IgG) were performed according to the manufacturer’s recommendations using the chemiluminescent microparticle immunoassay (CMIA) method (Architect, Abbott, Wiesbaden, Germany).

Results: Of the 2486 patients evaluated, 1341 (53.9%) were male, 1145 (46.1%) were female, and the average age was determined as 16.93 ± 19.5. EBV past infection was detected in 56.65% of the cases, the acute infection was detected in 17.25%, and 21.09% did not encounter EBV. Atypical serological profile was detected in 5.01%. As an atypical profile, the most common positivity of three antibodies together (3.90%), then isolated VCA-IgG positivity (0.91%), and isolated EBNA-1 IgG positivity (0.20%) were determined. It was determined that 24.24% of the cases with an atypical profile were immunosuppressive patient. 

Conclusions: The rate of encountering EBV in our study is 78.91%. The atypical EBV serological profile rate was found to be 5.01%. Approximately one-fourth of the cases with an atypical profile was found to be in the patient group with immune disorders. It is thought that antibody tests are not sufficient to determine the stage of infection, especially in these patient groups, and further tests should be performed. It has been demonstrated that serological monitoring is required for the interpretation of atypical profiles.